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Vaccination-Related Applications and Health Care Professionals’ Observed Changes in Human Papillomavirus Vaccine Hesitancy: Cross-Sectional Survey

JMIR Mhealth Uhealth. 2026 May 14;14:e77778. doi: 10.2196/77778.

ABSTRACT

BACKGROUND: Digital tools are known to promote public health interventions such as vaccine delivery. The recommendation that health care professionals (HCPs) use vaccination-related mobile apps or web-based applications has contributed to improving vaccine awareness and acceptance in the United States. The state of Texas, which has one of the lowest human papillomavirus (HPV) vaccination rates, has seen a significant increase in HPV vaccine hesitancy, particularly during the COVID-19 pandemic.

OBJECTIVE: This study aimed to examine the association between changes in HPV vaccine hesitancy observed by HCPs among patients in Texas and promotion of vaccination-related applications at the health care facilities where they practiced during the COVID-19 pandemic.

METHODS: A population-based cross-sectional survey was administered in 2021 by the MD Anderson Cancer Center to HCPs working in Texas using email addresses obtained from the LexisNexis Master Provider Referential Database. HCPs were asked if they assessed HPV vaccination status during every patient encounter. Those who responded “Often/Always” or “Sometimes” were subsequently asked whether they observed any change (“Decreased,” “No change,” “Increased,” or “Not sure”) in HPV vaccine hesitancy during the COVID-19 pandemic. Additionally, HCPs were asked whether their practice offers HPV vaccination. Those who responded “Yes” to this question were further asked whether vaccination-related applications are promoted at the facility where they practice, with response options being “Yes,” “No,” or “I don’t know.” Logistic regression analysis was performed to examine the association between changes in HPV vaccine hesitancy observed by HCPs and promotion of vaccination-related applications at the facility where they practice.

RESULTS: A total of 1283 HCPs completed the survey. Of the 730 HCPs who observed changes in HPV vaccine hesitancy, 51 (7%) reported a decrease in their patients’ HPV vaccine hesitancy. Of these 730 HCPs, 578 (79.2%) responded to the questions regarding vaccination-related applications, of whom 104 (18%) reported that vaccination-related applications were promoted at their facilities. Compared to HCPs who reported not promoting vaccination-related applications, those who reported doing so at their facilities had significantly higher odds of observing a decrease in HPV vaccine hesitancy among patients (adjusted odds ratio [aOR] 2.48, 95% CI 1.10-5.55; P=.03). HCPs working at federally qualified health centers or city, county, or public health care facilities (aOR 4.02, 95% CI 1.33-12.14; P=.01) and HCPs who administered the HPV vaccine under standing orders at their facilities (aOR 2.91, 95% CI 1.11-7.63; P=.03) had significantly higher odds of observing a decrease in HPV vaccine hesitancy at their practices.

CONCLUSIONS: Our findings suggest that promoting vaccination-related applications at health care facilities in areas with high HPV vaccine hesitancy such as Texas could further decrease HPV vaccine hesitancy in the population. This may be potentially applicable across diverse health care settings, particularly in the context of pandemic preparedness.

PMID:42133976 | DOI:10.2196/77778

By Nevin Manimala

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